U.S. patent number 5,116,373 [Application Number 07/567,803] was granted by the patent office on 1992-05-26 for pull-through appliance.
This patent grant is currently assigned to Protek AG, Sulzer Brothers Limited. Invention is credited to Hans Fluckiger, Stefan Freudiger, Roland P. Jakob, Rudolf Koch.
United States Patent |
5,116,373 |
Jakob , et al. |
May 26, 1992 |
Pull-through appliance
Abstract
The pull-through appliance is made of a mesh structure formed of
at least one continuous thread and a pullout thread disposed at one
end of the mesh structure to prevent unraveling of the mesh
structure. A hollow tube is used to facilitate drawing in of the
synthetic strand and autologous strand of the prosthesis. After
removal of the hollow member, the resulting package can be readily
threaded through a bore in a bone. After implantation, the pull-out
thread is removed and the mesh structure unraveled so as to remove
the mesh structure from within the bone.
Inventors: |
Jakob; Roland P.
(Hinterkappelen, CH), Freudiger; Stefan (Bremgarten,
CH), Koch; Rudolf (Berlingen, CH),
Fluckiger; Hans (Otwil, CH) |
Assignee: |
Sulzer Brothers Limited
(Winterthur, CH)
Protek AG (Berne, CH)
|
Family
ID: |
4248791 |
Appl.
No.: |
07/567,803 |
Filed: |
August 15, 1990 |
Foreign Application Priority Data
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Aug 28, 1989 [CH] |
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3108/89 |
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Current U.S.
Class: |
623/13.16 |
Current CPC
Class: |
A61F
2/08 (20130101); A61B 90/00 (20160201); D04B
19/00 (20130101); A61F 2/0805 (20130101) |
Current International
Class: |
A61B
19/00 (20060101); A61F 2/08 (20060101); D04B
19/00 (20060101); A61F 002/08 () |
Field of
Search: |
;623/1,11,12,13,16,66 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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0223370 |
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May 1987 |
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EP |
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2556210 |
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Jun 1985 |
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FR |
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Primary Examiner: Shay; Randy C.
Attorney, Agent or Firm: Kenyon & Kenyon
Claims
What is claimed is:
1. A pull-through appliance for pulling through a bore in a bone
comprising
a tubular textile mesh structure for receiving at least one of a
synthetic tendon prosthesis, a synthethic ligament prosthesis and
at least one of an organic ligament prosthesis and an organic
tendon prosthesis, said mesh being formed of at least one
continuous thread having a free end extending therefrom; and
a pull-out thread disposed at one end of said mesh structure to
prevent unraveling of said mesh structure, said pull-out thread
having a pair of free ends extending from said mesh structure.
2. An appliance as set forth in claim 1 wherein said mesh structure
is a knitted fabric.
3. An appliance as set forth in claim 1 which further comprises a
sterilizable dimensionally stable hollow member receiving said mesh
structure thereon.
4. A method of drawing a multistrand prosthesis through a bone
comprising the steps of
providing a tubular textile mesh structure formed of at least one
continuous thread and a pull-out thread at one end of the mesh
structure;
positioning a hollow member within the mesh structure;
drawing at least one of an organic tendon prosthesis and an organic
ligament prosthesis, and one of a synthetic ligament prosthesis and
a synthetic tendon prosthesis through the hollow member;
thereafter removing the hollow member from within the mesh
structure;
passing the mesh structure and two prostheses through a bore in a
bone;
thereafter pulling the pull-out thread from the mesh structure;
and
pulling a free end of the thread of the mesh structure to unravel
the mesh structure through the bore in the bone while leaving the
two prostheses in the bore.
5. In a pull-through appliance for pulling through a bore in a
bone, the combination comprising
a tubular textile mesh structure formed of at least one continuous
thread;
a pull-out thread disposed at one end of said mesh structure to
prevent unraveling of said mesh structure;
at least one organic prosthesis extending through said mesh
structure; and
at least one synthetic prosthesis extending through said mesh
structure.
6. The combination as set forth in claim 5 wherein said mesh
structure is a knitted fabric.
7. The combination as set forth in claim 5 which further comprises
a sterilizable dimensionally stable hollow member receiving said
mesh structure thereon and said prostheses therein.
8. The combination as set forth in claim 5 wherein said organic
prosthesis is one of a ligament prosthesis and a tendon
prosthesis.
9. The combination as set forth in claim 8 wherein said synthetic
prosthesis is one of a ligament prosthesis and a tendon prosthesis.
Description
This invention relates to a pull-through appliance. More
particularly, this invention relates to a tubular pull-through
appliance for pulling a ligament or tendon prosthesis through a
passage in a bone.
As is known, various techniques have been used for the implantation
of ligaments in the bone. For example, European Patent Application
0223370 describes a prosthetic ligament in the form of a tube
surrounded by a sheath of polyethylene which is secured to a cord
which serves as a means for pulling the ligament through a bore in
a bone.
It is has also been known from German Gebrauchsmuster U8706263 to
form tubes of mesh structure for transplants in knees.
In some cases, it has been known to replace ligaments or the like
which are no longer usable by means of autologous "prostheses"
taken from a patient only during an implantation operation. For
example, a piece of patellar tendon is often used as a prosthesis
for a cruciate ligament. Further, in order to prevent overloading
of an organic prosthesis of this kind, it has been known to implant
a synthetic ligament or tendon prosthesis in parallel relation to
the organic prosthesis such as a synthetic prosthesis, for example,
be in the form of a braided or woven textile band or strip or the
like and may be made of plastics, for example, a polyester.
Prostheses of this multiple strand kind often extend to some extent
through bores or passages in an adjacent bone. However, the pulling
of a prosthesis consisting of two or more strands s through a bone
is often a laborious and time-consuming task for the operating
surgeon.
Accordingly, it is an object of the invention to facilitate a
surgeons' task in drawing a multistrand prosthesis through a
bone.
It is another object of the invention to simplify the drawing of a
multistrand prosthesis through a bone during an implantation
procedure.
It is another object of the invention to provide a simple appliance
which can be readily used by a surgeon for the implantation of a
mutlistrand prosthesis.
Briefly, the invention provides a pull-through appliance for
pulling through a bore in a bone. The appliance is formed of a
tubular textile mesh structure for receiving at least one of a
synthetic ligament or tendon prosthesis and at least one of an
organic autologous ligament or tendon prosthesis wherein the mesh
is formed of at least one continuous thread. In addition, the
appliance includes a pull-out thread disposed at one end of the
mesh structure to prevent unraveling of the mesh structure.
The mesh structure is preferably constructed of a single layer
knitted fabric with a relatively long free end of thread extending
therefrom. In addition, the pull-out thread has a pair of
relatively long free ends extending from the mesh structure.
The pull-through appliance is sized so that a synthetic prosthesis
strand and an organic autologous prosthesis strand can be drawn
through the mesh structure so as to form a single unit which can be
readily pulled through a bore in a bone. Once the unit has been
pulled through the bone, the pull-out thread is removed, after
which, the mesh structure is unraveled or "undone" by pulling on
the free end of the thread. Undoing of the pull-through appliance
has proved to be very simple when the mesh structure is a knitted
fabric.
The threading of the various strands of the prosthesis into the
appliance can be facilitated when the mesh structure is drawn over
a sterilizable dimensionally stable hollow member.
These and other objects and advantages of the invention will become
more apparent from the following detailed description taken in
conjunction with the accompanying drawings wherein:
FIG. 1 illustrates a pull-through appliance drawn over a
sterilizable dimensionally stable hollow member in accordance with
the invention;
FIG. 2 illustrates a ready-to-pull-through "package" of a
pull-through appliance with one organic and one synthetic strand in
a prosthesis; and
FIG. 3 diagrammatically illustrates the position of the prosthesis
strands which have been drawn into a bore in a bone and which are
still surrounded to some extent by the pull-through appliance.
Referring to FIG. 1, the pull-through appliance includes a tubular
textile mesh structure 1 which is embodied by a single layer
knitted fabric having meshes produced by a single continuous thread
2. In addition, the mesh structure 1 is provided with a pull-out
thread 3 disposed at one end of the mesh structure 1 in order to
prevent unraveling of the mesh structure. As indicated, the end
meshes of the mesh structure 1 are retained on the pull-out thread
3. Further, the thread 2 of the mesh structure 1 has relatively
long free end which extends from the mesh structure 1. Likewise,
the pull-out thread 3 has a pair of relatively long free ends
extending from the mesh structure 1. These thread ends are sized so
as to project from a bore 5 in a bone 4 as illustrated in FIG. 3
after the pull-through appliance has been pulled through the bore
5.
The threads 2, 3 may be made primarily of plastic materials such as
polyethylene, polyester or polyamides, which have been tested and
proved satisfactory in the implant art. However, the pull-through
appliance may also be made of surgical sewing material.
In the illustrated embodiment, the mesh structure 1 is sized so as
to receive a two-strand prosthesis 6 comprised of a textile
synthetic auxiliary ligament prosthesis 7 which is, for example,
woven or braided and which is made of a plastic, for example, of
polyester, and an organic autologous tendon prosthesis 8, for
example, a piece of the patellar tendon.
In order to facilitate drawing in of the two prosthesis strands 7,
8, the mesh structure 1 is drawn over a sterilizable dimensionally
stable hollow member 9. For example, the hollow member 9 is made of
an appropriate plastic, such as polyester, polyethylene or
polyamide.
In use, the two strands 7, 8 are drawn through the hollow member 9.
Thereafter, the hollow member 9 is removed from within the tubular
mesh structure 1 so as to provide a ready-to-pull-through package
as shown in FIG. 2. Next, the resulting package which forms a
single strand flexible tube can be threaded by a surgeon through
the bore 5 in a bone 4 in a relatively simple fashion a indicated
in FIG. 3. After the flexible tube has been drawn through the bone
bore 5, the surgeon first pulls the pull-out thread 3 (not shown)
out of the end meshes of the mesh structure 1. Thereafter, the mesh
structure 1 is unraveled (i.e. "undone") by pulling on the free end
of the thread 2 so that finally only the two strands 7, 8 of the
prosthesis 6 extend through the bone 4.
The invention thus provides a relatively simple pull-through
appliance which can be readily used by a surgeon for the
implantation of a multistrand prosthesis in a bore of a bone.
Further, the invention provides a pull-through appliance which can
be readily removed after implantation by a simple unraveling of the
thread by which the appliance is made.
* * * * *